Key points

Corpora lutea

Pathophysiology and epidemiology

• Following ovulation, the remnants of the follicle become corpus luteum
• Produce estrogen and progesterone to prepare uterus for implantation
• Double corpus luteum has been associated with twin pregnancies and heterotopic pregnancies

Clinical presentation

• Identical to ovulation and/or pregnancies from single corpus luteum
• If pregnancy is heterotopic, patient may present with diffuse abdominal/pelvic pain, uterine bleeding or shock in cases of rupture

Imaging features

• Ultrasound: cystic structures within the right ovary with peripheral vascularity but not internal vascularity. A mass separate from the ovary should raise suspicion for heterotopic adnexal pregnancy with a nearby corpus luteum.

Treatment

• Expectant management for intrauterine pregnancies
• Medical and/or surgical management for heterotopic pregnancies

References

1. Bonde AA, Korngold EK, Foster BR, et al. Radiological appearances of corpus luteum cysts and their imaging mimics. Abdom Radiol (NY). 2016;41(11):2270-2282.
2. Durfee SM, Frates MC. Sonographic spectrum of the corpus luteum in early pregnancy: Gray-scale, color, and pulsed Doppler appearance. J Clin Ultrasound. 1999;27(2):55-59.
3. Kluckman ML, Schwope RB, Provagna AJ, Yauger BJ, Ramirez CI. The double corpus luteum: A novel sonographic sign of heterotopic pregnancy. J Clin Ultrasound. 2021;49(6):617-621.

Our appreciation is extended to Dr. Azfar Basunia, University of Pennsylvania Department of Radiology, for contributing this case.